HomeMy WebLinkAboutRelay Communications Center, Inc r-2-0.4,
� RESOLUTION 2023-356
ADOPTED DOC ID: 19056
THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO.2023-356 WAS
ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON
APRIL 11,2023:
RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs
Supervisor Scott A. Russell to execute a contract with Relay Communications Center Inc. for use .
of its FCC licensed radio frequencies,Radio Common Carrier paging and two way radio channel
service for one (1)year, for the period January 1, 2023 through December 1, 2023,for a total
cost of Six Thousand Two Hundred Fifty ($6,250.00) Dollars, subject to the approval by the
Town Attorney, funded from budget line A.3020.4.400.400.
Denis Noncarrow
Southold Town Clerk
RESULT: ADOPTED [UNANIMOUS]
MOVER: Brian O. Mealy, Councilman
SECONDER:Greg Doroski, Councilman
AYES: Nappa, Doroski,Mealy, Doherty, Evans, Russell
RECEIVED
o��Sv¢FOLk�O
h� o� APR 2 8 2023
a
Office of the Town Attorney
Town of Southold
Town Hall Annex, 54375 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone : 631-765-1939
Facsimile: 631-765-6639
MEMORANDUM
To: Denis Noncarrow, Town Clerk
From: Missy Mirabelli
Secretary to the Town Attorney
Date: April 27, 2023
Subject: Agreement between Town of Southold and Relay
Communications Center Inc
With respect to the above-referenced matter, I am enclosing the original
Agreement together with the Resolution.
If you have any questions regarding the enclosed, please do not hesitate to call
me. Thank you.
/mm
Enclosures
cc: Accounting
Southold PD
RELAY v
CALL CENTER • FULFILLMENT • ORDER ENTRY
v ANSWERING SERVICE • EMERGENCY RESPONSES Mr. Beeper
MS PE`a® CREDIT CARDS • HELP DESK • DEALER LOCATOR
e-mail: info@relaycom.com 2 WAY RADIOS • BEEPERS • CELLULARS www.relaycom.com
145 GRIFFING AVENUE • P.O.BOX 596 • RIVERHEAD,NEW YORK 11901 • PHONE:(631)727-8300 • FAX(631)727-5385 TOLL FREE(800)248-8330
April 27, 2023
TOWN OF SOUTHOLD
Office of the Town Attorney
Melissa M. Mirabelli, Secretary
54375 Route 25
Southold,NY 11971
RE: Modifications to the Agreement between the Town of Southold and Relay
Communications Center, Inc.
Dear Ms. Mirabelli:
Thank you for sending out the agreement between the Town of Southold and Relay
Communications Center, Inc. for the usage of our Radio Common Carrier channel for the seven
North Fork Fire Districts.
I have made changes on page one of the agreement as follows.
Article 1: Relay Communications Center, Inc. provides a complete backup system for the fire
district to use if and when needed. This backup system is only located at the Southampton tower
site. There is no backup system located on Shelter Island. This has been crossed out in the
agreement and initialed.
On the same page the agreement list six fire districts. The Orient Fire District is missing from the
agreement. I have added Orient Fire District for a total of seven (7) districts that we provide our
Radio Common Carrier channel access to. This has been initialed as well. This is included in the
annual cost to the Town and no additional cost are incurred for having Orient Fire District included.
Continued..........
We ate W6 w 74vo ` 0"
(2)
Included in the return of the signed agreement are copies of the Certificate of Insurance for both
liability and workers compensation as well as copies of the voucher and invoice.
Thank you for processing this on our behalf with the Town. If you require anything further please
feel free to reach out at relaveoni@aol.com and or by cell at 631-236-3553.
Si 11
Dennis G. Kenter
Telecommunications Manager
DGK:tyJ
AGREEMENT
THIS AGREEMENT, entered into this _ day of April, 2023, by and between the Town of
Southold,New York("the Town"), a municipal corporation organized and existing under the laws of
.the State of New York with offices at 53095_ Main Road, Southold, New York, and Relay
Communications Center, Inc. (the "Contractor"), with an address of PO Box 596, 145 Griffng Ave.,
Riverhead,New York, 11901;
WITNESSETH, that the Town and the Contractor, for the consideration hereinafter named,
agree as follows:
ARTICLE 1. WORK TO BE DONE AND CONSIDERATION THEREFOR
The Contractor shall provide the Town use of its exclusive FCC licensed radio frequencies,
Radio Common Carrier paging and two-way radio channel. The Contractor will also provide the use
and full service on the backup repeater/paging system located at its fflteitRihmrd-and Southampton
tower sites'as a backup system to the primary system. Any service requests will be addressed
Monday through Friday LOAM-3PM exclusive of holidays. The parties acknowledge that the
Contractor cannot guaranty the quality nor reception of radio services which are subject to equipment
failure, operator errors, omissions, terrain, atmospheric conditions or any interference created by
others.
The Contractor shall receive a system integration fee and license modification charges for three
sites for 2023 at a total cost of$6,250.00.
The Contractor will furnish the contemplated FCC licensed radio frequencies, Radio
Common Carrier paging and two-way radio,channel as well as the use and full service on the
backup repeater/paging system. Usage allows for the Town of Southold to utilize the Radio
® 1� Common Carrier for the North Fork primary paging channel for the benefit of the Fire
J Districts located 'at Mattituck, Cutchogue, Southold; Greenport, East Marion and Shelter
S Islan . This license also allows for a backup system located at Southampton, New York, to
serve as an emergency backup to the Town System. All other equipment and other similar
items necessary or proper for, or incidental to, the transmittals contemplated by this Contract,
are to be supplied by the Town.
ARTICLE 2. TERM OF AGREEMENT
The term of this agreement shall be from January 1,2023 through December 31,2023.
ARTICLE 3. ACCEPTANCE AND FINAL PAYMENT
Upon receipt of written notice that the Contract has been fully performed and an inspection by
the Town Supervisor to certify that the work has been completed to the satisfaction of the Town, the
Contractor will submit an itemized voucher to the Town Comptroller for payment. Such voucher
shall be due and payable within forty-five (45) days after receipt of such voucher, but such sum shall
not be due and payable by the Town until the Town Board of the Town has received such a voucher
and has audited and approved for payment the voucher to be submitted by Contractor in connection
therewith.
The Town Board shall process any voucher received from Contractor as expeditiously as
possible. In the event that the Town disputes or objects to any portion of any voucher submitted by
notify Contractor in writing of such dispute or objection. Contractor acknowledges that Contractor
is familiar with the requirements of section 118 of the Town Law which, in effect, prohibit payment
of any of Contractor's claims against the Town unless an itemized voucher therefore shall have been
presented to the Town Board or Town Comptroller and shall have been audited and allowed by the
Town Board or Town Comptroller.
The acceptance by the Contractor of the final payment shall be, and shall operate as a release to
the Town from all claims and all liabilities to the Contractor for all the things done or furnished in
connection with this work and for every act and neglect of the Town and others relating to or arising
out of, this Contract, except Contractor's claims for interest upon the final payment, if this payment
be improperly delayed. No payment, however final or otherwise, shall operate to release the
' Contractor or its sureties from any obligations under this Contract.
ARTICLE 4. CHANGES TO THE CONTRACT AND EXTRA WORK
(a) The Town may at times, without notice to the Contractor's surety and without
invalidating the Contract, order extra work or make changes by altering, adding to, or
deducting from the work contemplated herein and may adjust the Contract price
accordingly, pursuant to Paragraph (b) below. The Contractor shall not deviate from,
add to, delete from, or make changes in the Work required to be performed hereunder
unless so directed by a written Change Order. If the Contractor is directed by the Town
to perform extra work prior to an agreement on costs or time, the Contractor shall
promptly comply with the Change Order of the Town. No claim for extra work or any
change in the work shall be allowed or made unless such extra work or change is
ordered,by a written Change Order from the Town.
(b) The amount of compensation to be paid to the Contractor for any extra work, as so
ordered, shall be determined as follows:
1. By a lump sum mutually agreed upon by the Town and the Contractor; or
2. Using the applicable price or prices within the. Contract and/or Bid and approved
by the Town and the Contractor.
(c) Regardless of the method used by the Town in determining the value of a Change
Order, the Contractor shall submit to the Town a detailed payment breakdown of the
Contractor's estimate of the value of the omitted or extra work. i
(d) Unless otherwise specifically provided for in a Change Order, the agreed compensation
specified therein for extra work includes full payment for extra work covered thereby,
and the Contractor waives all rights to any other compensation for such extra work,
damage or expense, including claims for delay, damage or expense.
(e) The Contractor shall and hereby agrees to produce any and all data the Town may
request, including but not limited to, time sheets, certified payrolls, foreman's reports,
daily reports, bills and vouchers of Subcontractors, receiving documents, freight and
trucking receipts, etc.
(t7 All change orders shall be processed, executed and approved in the following manner:
(i) if the estimated cost of the extra work is less than $1,000 in the aggregate, a
Change Order Form must be processed and executed by the Supervising
Department Head;
(ii) if the estimated cost of the extra work is greater than $1,000, then the Change
Order Form must be executed by the Supervising Department Head and submitted
to the Town Board for consideration and approval by resolution. The Contractor
must submit a detailed explanation of why the Change Order is needed and must
also be submitted to the Town Board prior to its approval. The Change Order
must also be approved by the Town Comptroller and the Town Attorney. Once
this procedure is completed,the Contractor may proceed with the extra work.
The Town will not accept any alteration to this form and no payment for Extra Work
shall be due the Contractor unless it executes a Change Order on this Form.
(g) If the Contractor claims that any work which the Contractor has been ordered to perform
will be extra work, that the Contractor for any reason cannot comply with the terms and
provisions of the Contract, or that any action or omission of the Town is contrary to the
terms and provisions of the Contract and will require the Contractor to perform extra
work,the contractor shall:
1. Promptly comply with the Town's direction to perform the work which the
contractor claims will be extra work; and
2. Proceed diligently, pending and subsequent to the determination of the Town
with respect to any said disputed matter, with the performance of the work in
accordance with all the instructions of the Town.
(h) No claim for extra work shall be allowed unless it was performed pursuant to change
order duly approved by the Town Board. The Contractor's failure to comply with any
part of this provision shall be deemed to be:
1. A conclusive and binding determination on the part of the Contractor that said
change order, work, action or omission does not involve extra work and is not
contrary to the terms and provisions of the Contract, and
2. A'waiver by the Contractor of all claims for additional compensation, time or
damages as a result of said change work, act or omission.
(i) The value of claims for extra work, if allowed shall be determined methods described in
the Contract including, but not limited to, section (b) immediately above.
ARTICLE 5: CONTRACTOR'S OBLIGATIONS
(a) The Contractor shall be .responsible for the full and correct performance of the Work
required by this Contract within the time specified herein, including work of the
Contractor's Subcontractors, and any errors therein shall be corrected at the Contractor's
own cost and expense. In addition, the Contractor shall indemnify the Town for any costs
or expenses attributable to errors in performance by the Contractor or the Contractor's
Subcontractors.
ARTICLE 6. CONTRACTOR'S INSURANCE
The Contractor shall not commence work under this Contract until it has obtained all insurance
required under this paragraph and such insurance has been approved by the Town.
(a) Compensation Insurance: The Contractor shall take out and maintain during the life of
this Contract Workers' Compensation Insurance for its.employees to be assigned to the
work hereunder.
(b) Insurance: The Contractor shall take out and maintain during the life of this Contract
such general liability, property damage, and commercial auto liability insurance as shall
protect it from claims for damages for personal injury, including accidental death, as
well as from claims for property damage which may arise from operations under this
Contract. The amounts of such insurance shall be as follows:
General liability insurance in an amount not less than $1,000,000 for injuries, including
wrongful death to any one person and subject to the same limit for each person, in an amount not less
than $2,000,000 on account of any one occurrence.
Property damage insurance in an amount not less than $300,000 for damage on account of all
occurrences.
Commercial auto liability insurance in an amount not less than $500,000 for damage on
account of all occurrences.
The Contractor shall furnish the above insurances to the Town and shall also name the Town as
an additional named insured in said policies.
(c) Any accident shall be reported to the office of the Town Clerk'as soon as possible and
not later than twenty-four (24) hours from the time of such accident. A detailed written
report must be submitted to the Town as soon thereafter as possible and not later than
three (3) days after the date of such accident.
ARTICLE 7. REPRESENTATIONS OF CONTRACTOR
The Contractor represents and warrants:
(a) That it is financially solvent and that it is experienced in and competent to perform the
type of work or to furnish services required by it; and
(b) That it is familiar with all federal, state, municipal and department laws, ordinances and
regulations which may in any way affect the work or those employed therein.
ARTICLE S. PERMITS AND REGULATIONS
The Contractor shall comply with all permits and maintain FCC licensing in connection with the
services furnished under this Agreement.
ARTICLE 9. NO DAMAGES FOR DELAY
The contractor agrees to make no claim for increased costs, charges, expenses or
damages for delay in the performance of this Contract, or for any delays or hindrances from any
cause whatsoever, and agrees that any such claim shall be fully compensated for by an extension in
the time for substantial and/or .final completion of the work. Should the Contractor be or anticipate
being delayed or disputed in performing the work hereunder for any reason, it shall promptly, and in
no even more than two (2) business days after the commencement of any condition which is causing
or threatening to cause such a delay or disruption, notify the Town in writing of the effect of such
condition stating why and in what respects the condition is causing or threatening to cause such delay
or disruption. Failure strictly to comply with this notice requirement shall be sufficient cause to deny
Contractor a change in Schedule and to require it to conform to the Schedule then in effect.
ARTICLE 10. TOWN'S RIGHT TO STOP WORK OR TERMINATE CONTRACT
The Town shall have the right to stop work or terminate the Contract if:
(a) The Contractor is adjudged bankrupt or makes an assignment for the benefit of
creditors; or
(b) A receiver or liquidator is appointed for the Contractor or for any of its property and is
not dismissed within 20 days after such appointment or the proceedings in connection
therewith are not stayed on appeal within the said 20 days; or
(c) The Contractor refuses or fails to prosecute the work or any part thereof with due
diligence; or
(d) The Contractor fails to make prompt payment to persons supplying labor for the work; or
(e) The Contractor fails or refuses to comply with all applicable laws or ordinances; or
(f) The Contractor is guilty of a substantial violation of any provision of this Contract;
(g) The Town's execution and participation in this contract is found to be in violation of an
existing collective bargaining agreement.
(h) In any event, the Town, without prejudice to any other rights or remedy it may have,
may, with our without cause, by seven (7) days' notice to the Contractor, terminate the
employment of the Contractor and its right to proceed as to the work. In such case, the
Contractor shall not be entitled to receive any further payment beyond what owed in
quantum meruit. '
ARTICLE 11. DAMAGES
It is hereby mutually covenanted and agreed that the relation of the Contractor to the work to be
performed by it under this Contract shall be that of an independent contractor. As an independent
contractor, it will be responsible for all damage, loss or injury to persons or property that may arise in
or be incurred during the conduct and progress of said work,whether or not the Contractor, its agents,
or employees have been negligent. The Contractor shall hold and keep the Town free and discharged
of and from any and all responsibility and liability of any sort or kind. The Contractor shall assume
all responsibility for risks or casualties of every description, for loss or injury to persons or property
arising out of the nature of the work, from the action of the elements, or from any unforeseen or
unusual difficulty. The Contractor shall make good any damages that may occur in consequence of
the work or any part of it. The Contractor shall assume all blame, loss and responsibility of any
nature by reason of neglect or violation of any federal, state, county or local laws, regulations or
ordinances.
ARTICLE 12. INDEMNITY AND SAVE HARMLESS AGREEMENT
The Contractor agrees to indemnify and save the Town, its officers, agents and employees
harmless from any liability imposed upon the Town, its officers, agents and/or employees arising
from the negligence, active or passive, of the Contractor and from and against any damages, claims,
or expenses, including reasonable attorney's fees, arising out of Contractor's breach of the
Agreement or from Contractor's acts or omissions outside the scope of the Agreement or arising out
of claims or actions by third parties against Contractor by virtue of his performance of this
Agreement. The Town acknowledges that the Contractor is only providing the FCC licensed radio
frequencies and no other services to the Town. The Town is providing all equipment and systems
related to the dispatching and radio communications conveyed over the Contractor's frequency. The
Town agrees to indemnify and save the Contractor, its officers, agents and employees harmless from
any liability imposed upon the Contractor, its officers, agents and/or employees arising from the
negligence, active or passive, of the Town and from and against any damages, claims, or expenses,
including reasonable attorney's fees by virtue of its performance and use of the Town's own
equipment and systems.
ARTICLE 13. NO ASSIGNMENT
In accordance with the provisions of section 109 of the General Municipal Law,the Contractor
is hereby prohibited from assigning, transferring, conveying, subletting or otherwise disposing of this
Agreement, or of its right, title or interest in this Agreement, or its power to execute this Agreement,
to any other person or corporation without the previous consent in writing of the Town.
ARTICLE 14. REQUIRED PROVISIONS OF LAW
Each and every provision of law and clause required by law to be inserted in this Contract shall
be deemed to have been inserted herein. If any such provision is not inserted, through mistake or
otherwise, then upon the application of either party, this Contract shall be physically amended
forthwith to make such insertion. In particular, the Contractor shall, among other things, fully comply
with:
(a) Labor Law section 220-e and Executive Law sections 291-299 and the Civil Rights Law
relating to prohibition against discrimination and providing equal opportunity.
(b) Affirmative action as required by the Labor Law.
(c) Prevention of dust hazard required by Labor Law section 222-a.
(d) Preference in employment of persons required by Labor Law section 222.
(e) Eight-hour workday as required by Labor Law section 220(2).
ARTICLE 15. PREVAILING WAGE RATES REQUIRED BY LAW
(a) The parties hereto, in accordance with the provisions of section 220(3) of the Labor
Law, hereby agree, if applicable, that there shall be paid each employee engaged in
work tinder this Contract not less than the wage rate and supplements set opposite the
trade or occupation in which he/she is engaged, made a part of this Agreement, which
are the wage rates and supplements established as the prevailing rate of wages for the
work covered by this Contract.
(b) Labor classifications not appearing on the schedule of wages can be used only with the
consent of the Owner and then the rate to be paid will be given by the Owner after being
advised by the Department of Labor.
(c) The Contractor shall post in a prominent and accessible place on the site of the work a
legible statement of all wage rates and supplements, as specified in the Contract, for the
various classes of mechanics, workingmen/wornen, or laborers employed on the work.
ARTICLE 16. AUTHORITY FOR EXECUTION ON BEHALF OF THE TOWN
The Supervisor has executed this Agreement pursuant to a Resolution adopted by the Town
Board of the Town of Southold, at a meeting thereof held on April H, 2023_
Scott A. Russell, Supervisor, whose signature appears hereafter, is duly authorized and
empowered to execute this instrument and enter into such an Agreement on behalf of the Town. This
instrument shall be executed in duplicate. At least one copy shall be permanently filed, after
execution thereof, in the office of the Town Clerk, Denis Nonearrow.
ARTICLE 17. NOTICES
Any and all notices and payments required hereunder shall be addressed as follows, or to such
other address as may hereafter be designated in writing by either party hereto:
To Town: Denis Noncarrow
Southold Town Clerk
P.O. Box 1179
Southold,NY 11971-0959
To Contractor: Relay Communications Center,Inc.
PO Box 596
145 Griftuig Ave.
Riverhead,New York, 11901
ARTICLE 18. WAIVER
No waiver of any breach of any condition of the Agreement shall be binding unless in writing
and signed by the party waiving said breach. No such waiver shall in any way affect any other term
or condition of this Agreement or constitute a cause or excuse for a repetition of such or any other
breach unless the waiver shall include the same.
ARTICLE 19. MODIFICATION
This Agreement constitutes the complete understanding of the parties. No modification of any
provisions thereof shall be-valid unless in writing and signed by both parties.
ARTICLE 20. APPLICABLE LAW
This Agreement is governed by the laws of the State of New York. In the event of any
controversy or claim arising out of or relating to this Application for Service contract, or the breach
thereof, the parties specifically consent to Riverhead Justice Court, Suffolk County Court
Jurisdiction, or, if not applicable, the Supreme Court, State of New York, County of Suffolk.
IN WITNESS WHEREOF, the Town of Southold has caused these presents to be signed by
Scott A. Russell, its Supervisor, duly authorized to do so, and the Contractor has caused these
presents to be signed by its President, the day and year first above written.
Relay o cations Center, Inc.
By:
Name/Title:
Town of Southold
By:
Scott :Russell, Supervisor
I
STATE OF NEW YORK)
ss..
COUNTY nOF SUFFOLK)
On the o�-1 of Apr*1 'n the year 2023 before me, the undersigned, personally appeared
70&AtUA , personally known to me or proved to me on the basis of
satisfactory evidence to be the individual whose name is subscribed to the within instrument and
acknowledged to me that he executed the same in his capacity and that by his signature on the
instrument,the individual or the person upon whose behalf of which the individual acted, executed the
instrument.
/Notary Public
CFI�IS3'OPIiELJORDAN
ACotary Publlo-Sw Y®�c
No.01JOQualified In SntyIiAy Comltela�fon /2026
STATE OF NEW YORK)
) ss..
COUNTY OF SUFFOLK)
On the of April in the year 2023 before me, the undersigned, personally appeared Scott A. Russell,
personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose
name is subscribed to the within instrument and acknowledged to me that he executed the same in his
capacity and that by his signature on the instrument, the individual or the person upon whose behalf of
which the individual acted, executed the instrument.
Notary Public
LAUREN M.STANDISH
NOTARY PUBLIC,STATE OF NEW YORK
Registration No.01 ST6164008
Qualified in Suffolk County
Commission Expires April 9,20.1
CERTIFICATE OF LIABILITY INSURANCE °A'3/28/2023 '
Q3/2$I2423
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),
AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(lips)must be endorsed.If SUBROGATIONIS WAIVED,
subject to the berms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not
confer rights to the certificate Holder in lieu of such endorsement(%}.
PRODUCER CONTACT
HAYS COMPANIES INCIPHS '
42620333 PHONE (8&6)467-8730 FAX
The Hartford Business Servide Center (A(C.No.Eats (AfC.No):
3600 Wiseman Blvd E-MAIL
San Antonia,TX 78251 ADDRESS:
INSURERS)AFFORDING COVERAGE NA=
INSURED INSURERA: Hardbrd Casualty Insurance Company 25424
RELAY COMMUNICATIONS CENTER,INC INSURERS:
PO BOX 5961145 GRIFFING AVE
RIVERHEAD NY 11901 tNSURERC:
INSURER D
INSURER E:
b
INSURER F:
v
COVERAGES CERTIFICATE NUMBER. REVISION NUMBER: c
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATEDNOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE
TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INS TYPEOFINSURANCE ADDL SUER POLICY NUMBER POLICYEXP LIMITS
QTR OOMMEROIAL GENERAL LIABILITY EACH OCCURRENCE $1,0DD.000
CY )MS.MADE X OCCUR C� T� $300,000
X General Liability MED EXP(Any ane Pte►) $10.000
A X 42 SBA RR2663 04/26/2023 04126/2024 PERSONAL s AIN INJURY $1,000,000
COM AGGREGATE LIMIT APPLIES PER GENERAL ACCREGATE $21000.000 a
HmxYMrCTnX 00LOO PRODUCTS-COMPIOPAGG $2.0 .000
OTHER: �
AUTOMOBILELIABQJTY COMBINED SINGLE LIMIT
$1,000.000
ANYAUTO BODILY INJURY(Perpmm) _
A ALL OWNED SCHEDULED 42 SBA RR2563 04!2612023 0412612024 BODILY INJURY(Par aoddent) �� ...
AUTOS AUTOS
HIRED NON43WNED PROPERTY DAMAGE
X AUTOS X AUTOS {Peraorident)
UMBRELta LIAB X EACH OCCURRENCE $5.000.000
A ecus UABCEAIMS-
MADE 42 SBA RR2563 04/2612023 04/2612024aGCREGaTs $5.0001000
Eo X RETENTION$10,000
waRlcE�carriPENSATIaN P� OTM,
AND EMPLOYERS'LIABILITY a
AW YIN EL EACH ACCIDENT
PROPRIETORIPARTNERIEXECUTWE MI
OFFICERNEMSER EXCLUDED? A E.L.DISEASE-EA EMPLOYEE,,,--
(Mandstm'y In NH)
If yes.desaibo ueder EL DISEASE-POLICY LIMIT
DESCRIPTION OF OPERATIONS below
aESCR/FnaN CFOFFIPATrONSlLCCATX?i1rS/trMlffCt Es{ACORD 101.Addittanel Rwnd*0 Sahedut%may,be attached N mora®pato Its mquimQ
Those usual to the Insureds Operations.Certificate holder is an additional insured per the Business Liability Coverage Form SS0008 attached to this
Policy.
CERTIFICATE HOLDER C NCELLATION
Town of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
53095 ROUTE 25 BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED
SOUTHOLD NY 119714642 IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
tib INS-2015 ACORD CORPORATION.All rights reserved.
ACORD 2S(2016103) The ACORD name and logo are registered marks of ACORD
YTEW Workers' CERTIFICATE OF
STATE I Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE
BO�r{�
1 a.Legal Name&Address of Insured(use street address only) 1 b. Business Telephone Number of Insured
Relay Communication Center
631-727-8300
PO Box 596 1 c.NYS Unemployment Insurance Employer Registration Number of
Riverhead, NY 11901 Insured
0601305
Work Location of Insured(Only required if coverage is specifically limited to 1 d. Federal Employer Identification Number of Insured or Social Security
certain locations in New York State,i.e.,a Wrap-Up Policy) Number
PO Box 596, Riverhead, NY 11901
11-2852895
2.Name and Address of Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier
(Entity Being Listed as the Certificate Holder)
NorGUARD Insurance Company
Town of Southold
53095 Route 25 3b. Policy Number of Entity Listed in Box"I a"
Southold, NY REWC313302
Southold, NY 11971-4642 3c. Policy effective period
06/15/2022 to 06/15/2023
3d.The Proprietor;Partners or Executive Officers are
X❑ Included.(Only check box if all pariners/officers included)
all excluded or certain partners/officers excluded.
This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"1 a"for workers'
compensation under the New York State Workers'Compensation Law. (To use this form, New York(NY) must be listed under Item 3A
on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send
this Certificate of Insurance to the entity listed above as the certificate holder in box"2".
The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled
due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or
eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.)Otherwise,this
Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy
expiration date listed in box"3c",whichever is earlier.
This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend,
extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the
referenced policy.
This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect.
Please Note: Upon cancellation of the workers'compensation policy indicated on this form, if the business continues to be
named on a permit, license or contract issued by a certificate holder, the business must provide that certificate holder with a
new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the
mandatory coverage requirements of the New York State Workers'Compensation Law.
Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced
above and that the named insured has the coverage as depicted on this form.
Approved by: Dave Simmons
(Print name of authorized representative or licensed agent of insurance carrier)
Approved by: 4L , �-7,' 1- , 04/26/2023
.... «.. (Date)
Title: Vice President of Sales
Telephone Number of authorized representative or licensed agent of insurance carrier: 800-673-2465
Please Note:Only insurance carriers and their licensed agents are authorized to issue Form C-105.2.Insurance brokers are NOT
authorized to issue it.
C-105.2 (9-17) www.wcb.ny.gov
Vendor No. CbeckNo -';:
Town of Southold, New YorkPayment
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Payee Certift at+lon Department Certification ^
neunde %rad(Claimant)(Actingon behalfofthe above named claimant) I hereby cad y that the materials above specified have been received by me
does h=by certify that the foregoing claim is trra and comect,dot no pmt has in good condition without substitution,dw services properly
been paid,c>wW as therein stated,drat the Wlw=limbi stated is actually performed and that the quantities thereofbava been vtritied with the exceptions
due and owing, d that from which the Town is exempt are txchude& or discrepancies noted,and payment is approved.
signapuo Tido—_ 1�h Signature
Company Name �� DateQ�a�i c oZ� Title Date
Relay Communications Center Invoice
145 Griffing Avenue Date Invoice#
Post Office Box #596
1/3/2023 777-23377
Riverhead, NY 11901
Bill To
Town of Southold
Attn: Scott A. Russell, Supervisor
P.O. Box 1179
Southold, NY 11971
Description Amount
Annual FCC license usage for North Fork Fire Districts paging. Usage allows for the Town 6,250.00
of Southold to use the Radio Common Carrier channel for the North Fork primary paging
channel. This license also allows for a backup system located at Southampton NY to serve
as an emergency backup to the Town system. This is as per the agreement between the
Town of Southold and Relay Communications Center, Inc.
Time Frame: January 1, 2023- December 31, 2023
Fire Districts Service is Provided For:
Mattituck, Cutchogue, Southold, Greenport, East Marion, Orient and Shelter Island.
Note: FCC license remains under the assignment of Relay Communications Corporation.
Thank You!!
Police Budget Line Item: "Communications Services"
Sales Tax 0.00
It's been a pleasure working with you!
Total $6,250.00